Assessments of methodological and reporting quality are critical to adequately judging the credibility of a study's conclusions and to gauging its potential reproducibility. To aid those seeking to assess the methodological or reporting quality of studies relevant to toxicology, we conducted a scoping review of the available guidance with respect to four types of studies: in vivo and in vitro, (quantitative) structure-activity relationships ([Q]SARs), physico-chemical, and human observational studies. Our aims were to identify the available guidance in this diverse literature, briefly summarize each document, and distill the common elements of these documents for each study type. In general, we found considerable guidance for in vivo and human studies, but only one paper addressed in vitro studies exclusively. The guidance for (Q)SAR studies and physico-chemical studies was scant but authoritative. There was substantial overlap across guidance documents in the proposed criteria for both methodological and reporting quality. Some guidance documents address toxicology research directly, whereas others address preclinical research generally or clinical research and therefore may not be fully applicable to the toxicology context without some translation. Another challenge is the degree to which assessments of methodological quality in toxicology should focus on risk of bias - as in clinical medicine and healthcare - or be broadened to include other quality measures, such as confirming the identity of test substances prior to exposure. Our review is intended primarily for those in toxicology and risk assessment seeking an entry point into the extensive and diverse literature on methodological and reporting quality applicable to their work.
Dual antiplatelet agents and high-intensity statins are frequently used in combination after myocardial infarction. Ticagrelor has the potential of causing acute kidney injury. Rosuvastatin is excreted through the kidneys and dose adjustment is needed in patients with kidney disease. When used in combination, they can potentiate the toxic effects of each other. We report a case of drug interaction between rosuvastatin and ticagrelor resulting in rhabdomyolysis and acute renal failure necessitating dialysis. This case stresses the importance of monitoring renal function and adjusting the dose of rosuvastatin accordingly in patients with kidney disease.
BACKGROUND Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths in the United States. Still, 1 in 3 adults aged 50 years to 75 years have not been screened for CRC. Early detection and management of precancerous or malignant lesions has been shown to improve overall mortality. AIM To determine the most significant facilitators and barriers to CRC screening in an outpatient clinic in rural North Carolina. The results of this study can then be used for quality improvement to increase the rate of patients ages 50 to 75 who are up to date on CRC screening. METHODS This retrospective study examined 2428 patients aged 50 years to 75 years in an outpatient clinic. Patients were up to date on CRC screening if they had fecal occult blood test or fecal immunochemical test in the past one year, Cologuard in the past three years, flexible sigmoidoscopy/virtual colonoscopy in the past five years, or colonoscopy in the past ten years. Data on patient socioeconomic status, comorbid conditions, and other determinants of health compliance were included as covariates. RESULTS Age [odds ratio (OR) = 1.058; P = 0.017], no-show rate percent (OR= 0.962; P < 0.05), patient history of obstructive sleep apnea (OR = 1.875; P = 0.025), compliance with flu vaccinations (OR = 1.673; P < 0.05), compliance with screening mammograms (OR = 2.130; P < 0.05), and compliance with screening pap smears (OR = 2.708; P < 0.05) were important factors in determining whether a patient will receive CRC screening. Race, gender, insurance or employment status, use of blood thinners, family history of CRC, or other comorbid conditions including diabetes, hypertension, congestive heart failure, chronic obstructive pulmonary disease, and end-stage renal disease were not found to have a statistically significant effect on patient adherence to CRC screening. CONCLUSION Patient age, history of sleep apnea, and compliance with other health maintenance tests were significant facilitators to CRC screening, while no-show rate percent was a significant barrier in our patient population. This study will be of benefit to physicians in addressing and improving the CRC screening rates in our community.
Mesoamerican nephropathy (MeN), formerly called chronic kidney disease of unknown cause (CKDu), refers to chronic kidney disease (CKD) that presents in young and middle-aged Central Americans in the absence of any clear etiology. MeN is a relatively new diagnosis with rapidly rising prevalence in specific regions of El Salvador and Nicaragua, Guatemala, and Costa Rica. It is seldom associated with hyperuricemia. We present a case of a patient with gouty arthritis and hyperuricemia with associated CKD due to MeN. We also provide a review of literature of this disease.
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